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新生儿、儿童和青少年的抗凝治疗。

Anticoagulation therapy in neonates, children and adolescents.

机构信息

Haematology Research, Murdoch Childrens Research Institute, Royal Children's Hospital, Flemington Road Parkville, VIC 3052, Australia.

Department of Pediatrics, McMaster University, Hamilton, ON, Canada.

出版信息

Blood Cells Mol Dis. 2017 Sep;67:41-47. doi: 10.1016/j.bcmd.2017.05.008. Epub 2017 May 13.

Abstract

Anticoagulation of neonates, children and adolescents remains an important part of clinical care for many individuals. There are different options for anticoagulation, each with their own advantages and disadvantages and selection of an appropriate anticoagulation regime for the specific condition should be judicious. This is in part because age related differences in the coagulation systems exist that mean that the pharmacokinetics and pharmacodynamics of anticoagulation drugs vary across the pediatric spectrum in addition to being distinct from adults. The use of anticoagulant drugs presents specific challenges in the pediatric setting. This review will consider the main anticoagulants currently in use in neonates, children and adolescents, specifically Heparin (unfractionated heparin and low molecular weight heparin) vitamin K antagonist (warfarin) as well as a brief discussion of fondaparinux.

摘要

新生儿、儿童和青少年的抗凝治疗仍然是许多患者临床治疗的重要组成部分。有许多不同的抗凝选择,每种选择都有其自身的优缺点,应根据具体情况谨慎选择合适的抗凝方案。这在一定程度上是因为凝血系统在年龄上存在差异,这意味着抗凝药物的药代动力学和药效动力学在儿科范围内存在差异,与成人不同。在儿科环境中使用抗凝药物会带来特殊的挑战。本篇综述将考虑目前在新生儿、儿童和青少年中使用的主要抗凝药物,具体包括肝素(普通肝素和低分子量肝素)、维生素 K 拮抗剂(华法林),以及对磺达肝癸钠的简要讨论。

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